leg length discrepancy: often not the same as a difference in leg length

Leg length discrepancy; why not always treat as such!

Numerous articles and comments have been written about leg length discrepancy (LLD).  How to measure it, how to test it, how to treat it.

I have often been consulted by patients who, according to their physician or therapist, should have a leg length discrepancy. This LLD however was never diagnosed before or known from their youth. Most of these patients had no medical history of broken legs or complicated fractures. Testing them in a laying and standing position I measured indeed this LLD.

In many cases I then noticed also a pelvis rotation around the longitudinal body axis. I asked the laying patient to bend both knees, resting the feet, leaving the knees free to move. Almost always one or even two knees moved to one side.   A lumbar support under the side towards the pelvis was rotating, made, nine out of ten times, the LLD disappear. In my experience this was not a ‘real’ LLD but a ‘physiologic’ one. Many professionals, for instance hairdressers, stand their whole working life most on one leg. The muscles of the foot/leg/hip at that side contract and a ‘created LLD’ is born! Do not start to treat this as a shorter leg by means of heel orthotics because the pelvis will rotate even more!!

June, 2019.

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